As physicians who treat patients with epilepsy, we find ourselves considering whether the seizures patients describe to us have sufficient impact to warrant removal of driving privileges or other special safety considerations. These decisions are often clear-cut, based on the patients'or observers'descriptions. When a patient indicates that they are not aware of their own activities-or the activities of those around them-it is relatively easy to determine that consciousness is impaired, and therefore driving privileges should be removed. However, there are seizure descriptions that seem to fall on a gray line: For example, the patient who experiences the seizure may relate that they are aware of the presence of others throughout the seizure, can hear conversations, but perhaps cannot report or remember exact conversations because the experience of the seizure is"so intense"that it takes all of the person's attention.
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